MSK - Back and Vertebrae Flashcards
What are the function of the vertebral column?
- support and balance
- protection of the spinal cord in the spinal canal
- flexibility
What is the morphology of the vertebral column?
- embryos = spine is C shaped
- when we learn how to walk our muscle start to build and form the primary curvature => thoracic kyphosis and sacro-coccygeal kyphosis
- as we get older and excersise, body weight shifts and secondary curvatures form => lumbar lordosis and cervical lordosis
what are the primary and secondary curvatures that form as we get older?
- when we learn how to walk our muscle start to build and form the primary curvature => thoracic kyphosis and sacro-coccygeal kyphosis
- as we get older and excersise, body weight shifts and secondary curvatures form => lumbar lordosis and cervical lordosis
Where are the deviations in scoliosis?
lateral deviations in posterior aspect (in the primary curvature)
What is the spine made of?
What are the different vertebrae of the spine?
32-33 vertebra - lower ones have larger bodies to support weight
- cervical - 7
- thoracic - 12
- lumbar - 5
- sacrum - 5
- coccyx - 3 (fused)
Which are the atypical cervical vertebrae?
atlas (C1) and axis (C2), C7
What is the typical structure of cervical vertebrae?
- oval-shaped body
- pedicle => attaching body to articular facet
- superior articular facet
- lamina => attach articular facet to spinous process
- bifid spinous process
- vertebral foramen =.when vertebrae stacked on top of each other and forms spinal canal
- transverse process
- transverse foramen => passageway to allow the vertebral arteries to supply the brain through the foramen magnum
- inferior articular facet
What is the joint when the articular facets join ?
zygapophyseal - there is a joint capsule and synovial fluid on top
What are the features of atlas? (c1)
1) Superior articular facet (articulates with occipital condyles forming altanto-occipital joint)
2) No body - posterior arch instead
3) Allows you to say yes - allowing for flexion and extension
4) No spinous process
What are the features of axis? (c2)
1) Dens (body of atlas) - articulates with the vertebral odontoid process atlantoaxial joint
2) Superior articular facet (where the atlas sits)
3) Allows you to say no
What is the function of the dens?
dens acts as pivot allowing atlas and the occipital bone above for the head to rotate on axis side to side
label
NO ZYGOPOPHASYEAL JOINT BWTWEEN C1 AND 2
What is the structure of a typical thoracic vertebrae?
- transverse process => articulate with the tubercle of rib
- spinous process => long and projecting downward
- superior and inferior articular processes
- superior articular demi-facet (articulates with head of rib)
- inferior articular demi-facet (articulates with head of next rib)
- body => heart shaped
What is the structure of typical lumbar vertebrae?
- body => progressive increase in mass
- spinous process => horizontal and square shaped
- vertebral foramen => rounded
- superior articular facet (more vertical)
- intervertebral foramen formed
- zygapophyseal joint holding the articular facet together
- mammillary process => multifidus muscle attaches here to support he back throughout the whole length
What is the structure of typical lumbar vertebrae?
- body => progressive increase in mass
- spinous process => horizontal and square shaped
- vertebral foramen => rounded
- superior articular facet (more vertical)
- intervertebral foramen formed
- zygapophyseal joint holding the articular facet together
- mammillary process => multifidus muscle attaches here to support he back throughout the whole length
Features of the sacrum
- articular facet on the superior of the sacrum articulates with the inferior articular process of the 5th LV
- sacral crest
- wings of ala => articulate with ilium of pelvis
- dorsal foramina => where sacral arteries and nerves pass through
How do the coccyx and sacrum articulate?
through the cornu coccygeus articulating with the corna of sacrum
- 3 to 4 coccyx fused
EVERYTHING CORN
summarise the diff vertebrae
What are intervertebral discs?
What is the function of intervertebral discs?
What is the structure of intervertebral disc?
What is the intervertebral disc a remnant of?
and label
- fibrocartilage between vertebrae which provide string attachment between vertebral bodies
- shock absorbers
- outer anulus fibrosus (consisting of type 1 and 2 collagen fibres) and inner nucleus pulposus
- remnant of notocord
how do teh vertebrae articulate with eachother? the joints
What is degenerative disc disease?
disc becomes thinner with age and loses its shock absorbing ability
- space between vertebrae get smaller and bone spurs occur
What are bone spurs?
bony projections where bones meet and rub due to friction
- cause nerve to be pinched causing numbness and tingling
What is the structure of the spinal cord? and where does epidural go?
- Inner gray matter (unmyelinated axons)
- Outer white matter (myelinated axons)
- long, thin tubular structure extending from medulla oblongata in the brainstem to lumbar region and terminates at L1
- spinal nerves then branch off to form the cauda equina and then the filum terminale
goes between in teh arichinoid speace
Where is the blood supply of the spinal cord from?
mostly from the descending aorta
- highly porous and well supplied with the blood vessels and therefore ideal slot for cancer cells to spread
Where is cerebrospinal fluid produced?
clear colourless fluid produced by choroid plexus
label
what is cauda equina
The cauda equina is a group of nerves and nerve roots stemming from the distal end of the spinal cord, typically levels L1-L5 and contains axons of nerves that give both motor and sensory innervation to the legs, bladder, anus, and perineum
What is the filum terminale?
delicate strand of fibrous tissue joining spinal cord to the coccygeal teres
- 1st part is pia mater extension - reaching lower border of 2nd sacral vertebra
- 2nd part is dura mater extension - attaching to first segment of coccyx
What are the spinal meninges?
OUTER => dura mater, arachnoid mater, pia mater <= INNER PAD
How is the brain protected?
meninges which is continuous with the spinal meninges
What is the epidural space?
Cushion of fat and network of veins in space between vertebrae and spinal dura mater - site for anaesthetic injections
What is the subarachnoid space?
space between arachnoid and pia mater, filled with CSF
- will spawn lumbar cisterna when spinal cord ends at L2
Feature of arachnoid mater
made of elastic fibres
What is the denticulate ligament?
comes off of pia matter - anchors spinal cord to meninges
A tooth-like lateral extension of pia mater off the spinal cord anchoring spinal cord to meninges
How many spinal nerves are there?
31 pairs: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
Why are there 8 pairs of cervical nerves?
the first pair pass between the skull and C1
What is the route of the spinal nerve root?
SENSORY RECEPTOR
1. dorsal ramus
2. dorsal root ganglion
3. sensory axon and cell body
4. dorsal root
5. ventral root
6. axon of motor neurone
7. ventral ramus
8. neuromuscular junction
EFFECTOR
DOrsal is sensory and ventral is effectro
What are the movements of the spine?
What allows for movements of the spine?
- rotation
- lateral flexion
- flexion
- extension
ligaments
What is this?
ant ligaments
arises from the occipital bone and spans across the entire spine along the anterior aspect, ending on the antero-superior portion of the sacrum
- broadens as it descends
What is this ?
posterior ligament
arises from C2 body and travels immediately posterior to vertebral bodies and intervertebral discs, attaching it to the back of the sacrum
- narrows as it descends
What is the this?
interspinous ligament
posterior ligament which joins the spinous process fusing with the strong supraspinous ligament
- limits flexion
What does this ?
joins tips of the spinous process
supraspinous ligament
What is the ligamentum flavum?
paired ligaments (right and left) that run between lamina of adjacent vertebrae.
- yellow and elastic ligament
- starts off thin and becomes progressively thicker
What is the ligamentum nuchae?
Where does the ligamentum nuchae span from?
What is the ligamentum nuchae an extension of?
What is the function of the ligamentum nuchae?
- large median ligament composed of tendons and fascia located between the posterior muscle of neck
- external occipital protuberance and medial nuchal line to the spinous process of C7 attaching all posterior tips of C1 to C6 spinous process
- supraspinous ligament
- limit hyperflexion of neck
what is this
ligamentum flavum
label
What is the intertransverse ligaments?
joins adjacent transverse process of adjacent vertebrae - very thin fibrous cords
What are the divisions of the back muscle?
back muscles (spanning from back of neck to sacrum covered by deep fascia) => extrinsic (superficial and intermediate) and intrinsic (deep)
What is the superficial group of back muscles? and function
spinotransversales muscle: slenius capitis and splenius colli
- rotation of the head (same side)
- extension of neck
- lateral flexion of neck
what are the intermediate group of muscles? and function
erector spinae muscles
- 3 large and long running on back of spine forming a column called erector spinae
- spinalis, longissimus, iliocostalis
function of erector spinae:
- lateral flexion of vertebral column
- contract bilaterally to extend vertebral column and head
- connection with pelvis to stabilise the column
What are the deep group of muscles? and function
transversospinalis - associated with transverse and spinous processes
- stabilise the spine by holding together the vertebrae
- semispinalis extend (through bilateral contraction) and rotate (unilateral contraction) the head, neck and trunk
What are 3 segmental muscles of the back?
- interspinales = spans between adjacent spinous process and stabilises the vertebral column (stabilises the vertebral column)
- intertrasnversari = span between adjacent transverse process (stabilise the vertebral column)
- levatores costarum = originate from transverse process of C7-T11 attaching to the rib immediately below (elevates the ribs)
